PCOS - Everything You Need to Know
(Polycystic Ovarian Syndrome)
What is PCOS?
In each menstrual cycle, follicles grow on the ovaries. Eggs develop within those follicles, one of which will reach maturity aster than the others and be released into the fallopian tubes. This is "ovulation". The remaining follicles will degenerate.
In the case of polycystic ovaries, however, the ovaries are larger than normal, and there are a series of undeveloped follicles that appear in clumps, somewhat like a bunch of grapes. Polycystic ovaries are not especially troublesome and may not even affect your fertility.
However, when the cysts cause a hormonal imbalance, a pattern of symptoms may develop. This pattern of symptoms is called a syndrome. These symptoms are the difference between suffering from polycystic ovary syndrome and from polycystic ovaries.
So you can have polycystic ovaries without having PCOS. However, nearly all women with PCOS will have polycystic ovaries. Polycystic Ovary Syndrome is the name given to a metabolic condition in which a woman will have polycystic ovaries, along with a certain pattern of other symptoms that reflect imbalances in reproductive and other hormones.
Let's define some terms:
- "Syndrome" simply means a set of symptoms that occur together, in a pattern.
- "Polycystic" means there is an accumulation of incompletely developed follicles (cysts) in the ovaries.
- "Polycystic ovarian syndrome" refers to a health disorder where there may be many cysts in the ovaries, accompanied by a distinctive pattern of symptoms.
- "Metabolic" refers to the physical and biochemical processes required for the body to function.
"Polycystic ovary syndrome" is the name given to a metabolic condition in which a woman will have cystic ovaries, along with a certain pattern of other symptoms that reflect imbalances in reproductive and other hormones.
We referred to polycystic ovary syndrome as a "metabolic disorder". By this we mean that there are numerous factors in basic body processes that have gone awry. Because your body is a unified whole, a problem or dysfunction in one area causes dysfunction in other areas. Polycystic ovary syndrome is a dysfunction that is related in some way to your whole body, not just your ovaries.
How Common Is PCOS?
Polycystic ovary syndrome is the most common hormonal disorder occurring in women during their reproductive years. It's thought that 4% to 10% of all women have the disorder. However, since many women don't know they have polycystic ovarian syndrome or some aspect of it, the actual number probably exceeds 10%. Polycystic ovarian syndrome is one of the leading causes of infertility. Symptoms frequently start to show up soon after puberty.
What Causes Polycystic Ovarian Syndrome?
There is disagreement and uncertainty as to what causes polycystic ovarian disease. Polycystic ovaries and polycystic ovary syndrome symptoms have been associated with one or more of these factors:
- Genetic predisposition.
- Abnormal fetal programming
- Insulin resistance or hyperinsulinism (high blood levels of insulin).
- Hyperandrogenism (excessive production of male hormones).
- Abnormality of the hypothalamic-pituitary-gonadal axis (organ/hormonal disorder).
- Environmental chemical pollution (hormonal disrupters)
- Food adulteration (excitatory amino acids, for example)
- Chronic inflammation.
- Gut dysbiosis.
Some of these causal factors may also be consequences of polycystic ovary disease. In other words, we have an amazingly complex network of interacting variables, each of which influences the other. Polycystic ovarian syndrome is not a simple disease with a single cause.
Chapter 2 of the The Natural Diet Solution for PCOS and Infertility describes the possible causes of polycystic ovary syndrome in great detail.
Polycystic ovarian syndrome presents a complex and baffling array of signs, symptoms and indications. The condition is associated with some combination of the following symptoms and indications that vary widely with each individual:
- Multiple ovarian cysts
- Irregular or absent menses
- Obesity or inability to lose weight
- Excessive body or facial hair (hirsutism)
- Insulin resistance and possibly diabetes
- Thinning of scalp hair
- Velvety, hyperpigmented skin folds (acanthosis nigricans)
- High blood pressure
- Polycystic ovaries that are 2-5 times larger than healthy ovaries.
- Impaired lung function
- Sleep apnea
- Fatty liver degeneration (NAFLD)
- Disordered immune system
- Mood disorders, including anxiety and depression
- Appetite disorder
- High blood fats (cholesterol and triglycerides)
- Increased risk of developing cardiovascular disease
- Increased risk of developing diabetes
- Bacterial infection (H. pylori)
- Increased sensitivity to chronic stress
- Evidence of auto-immune disorders such as Hashimoto's thyroiditis
- Dry eye syndrome
- Iron overload
- Multiple hormone imbalances, commonly including:
- Abnormal menopause
How Is It Diagnosed?
How it is diagnosed depends on what criteria are used.
The first diagnostic classification was developed in 1990 by the National Institutes of Health. The diagnostic classification required the simultaneous presence of hyperandrogenism (excessive levels of male hormones) and menstrual dysfunction in order to diagnose polycystic ovarian syndrome.
Then in 2003, an expert panel met in Rotterdam and expanded on the previous criteria. They added the presence of PCO (polycystic ovaries) as detected by transvaginal ultrasound. This newer classification broadened the number of women to be diagnosed with PCOS. It included women with irregular periods and polycystic ovaries without hyperandrogenism (abnormally high male hormones), or hyperandrogenism and polycystic ovaries without menstrual dysfunction.
In 2006, the Androgen Excess Society published diagnostic criteria which required the presence of clinical or biochemical hyperandrogenism (abnormally high male hormones), with either polycystic ovaries or menstrual dysfunction to diagnose PCOS.
The Rotterdam diagnostic classification is the one that is most commonly used.
Click here for more information about how polycystic ovarian syndrome is treated, and what the consequences are if you do not effectively manage this serious health disorder.
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